Acquired immunodeficiency syndrome (AIDS) was first described in 1981, and continues to be one of the worst global health pandemics in recorded history. Concerted international efforts have helped to increase awareness of human immunodeficiency (HIV) status, improve access to treatment and continuation of therapy to achieve viral suppression with a goal of ending the AIDS epidemic by 2030. The clinical outcomes for patients living with HIV on combined antiretroviral therapy are considerably improved with prolonged life expectancy and superior quality of life. Further, perinatal transmission rates have dramatically decreased with elimination of mother to child transmission of HIV in a growing number of countries worldwide. However, there have been significant reductions in the pace of progress in treatment expansion for pregnant women with failure to meet global targets in 2018. In this review, we will highlight recent advances and challenges ahead in 2020 for three areas of perinatal care for women with HIV in developed countries: (a) pregnancy planning considerations, (b) impact of antiviral medications on perinatal outcomes, and (c) infant feeding practices. The promise of a HIV-free generation is on the horizon and continued international efforts in preventing perinatal transmission are an important component of this achievement. 相似文献
The effectiveness of various forms of caution signs was evaluated using saccadic eye movements and reaction time as the dependent variables. Both dependent measures show that caution signs requiring specific positive actions are processed more slowly and less efficiently than signs requiring avoidance behaviors. Additionally, the data show that changing the order of the “consequences” and “instructions” elements of the caution signs did not influence the number of saccades, the speed, or accuracy of interpretation. The research shows that saccadic eye movement may be an effective method for evaluating the design of caution signs. 相似文献
There is increasing interest among scholars in producing information that is useful and usable to land and natural resource managers in a changing climate. This interest has prompted transitions from scientist- to stakeholder-driven or collaborative approaches to climate science. A common indicator of successful collaboration is whether stakeholders use the information resulting from the projects in which they are engaged. However, detailed examples of how stakeholders use climate information are relatively scarce in the literature, leading to a challenge in understanding what researchers can and should expect and plan for in terms of stakeholder use of research findings. Drawing on theoretical, typological, and evaluation insights from the field of information use, we examine stakeholder use of climate information emerging from 13 collaborative climate science projects conducted in the western United States between 2012 and 2016. Three primary types of use emerge from our findings—conceptual, instrumental, and justification—reflecting common typologization of information use. Conceptual use was the most predominant. We suggest that researcher awareness of this typology can enable more systematic understanding of what project outputs stakeholders use and impacts of those outputs, giving way to new areas of inquiry and aiding in the conceptualization and design of climate information products for land and natural resource managers. 相似文献
Bunte, Kristin, John P. Potyondy, Kurt W. Swingle, and Steven R. Abt, 2012. Spatial Variability of Pool-Tail Fines in Mountain Gravel-Bed Stream Affects Grid-Count Results. Journal of the American Water Resources Association (JAWRA) 48(3): 530-545. DOI: 10.1111/j.1752-1688.2011.00629.x Abstract: Fine sediment (<2 and <6 mm) particles underlying a 49-intersection grid placed on a streambed at 25, 50, and 75% of the wetted pool-tail width are commonly counted to assess the status and trend of aquatic ecosystems or to monitor changes in the supply of fines in mountain gravel-bed streams. However, results vary even when crews perform nearly identical procedures. This study hypothesized that spatial variability of pool-tail fines affects grid-count results and that a sampling scheme can be optimized for precision and accuracy. Grid counts taken at seven evenly spaced locations across the wetted width of 10 pool tails in a pool-riffle study stream indicated a bankward fining trend with secondary peaks of fines within the stream center. Sampling locations close to the waterlines harbored more than twice as many fines as central locations. Most of the five grid-count schemes derived from the seven sampled locations produced significantly different results. Compared with sampling at all seven locations, schemes that focus near waterlines overpredicted fines, while those that focus on the center underpredicted them. Variability of fines among pool tails was the highest within a broad band along the waterlines; hence, focusing sampling there yielded the most variable results. The scheme sampling at 25, 50, and 75% of the wetted width had the lowest precision and moderate accuracy. Accuracy and precision of grid-count results can be greatly improved by sampling at seven even-spaced locations across the pool tail. 相似文献
Objective: As vehicle safety technologies and evaluation procedures advance, it is pertinent to periodically evaluate injury trends to identify continuing and emerging priorities for intervention. This study examined detailed injury distributions and injury risk trends in belted occupants in frontal automobile collisions (10 o’clock to 2 o’clock) using NASS-CDS (1998–2015).
Methods: Injury distributions were examined by occupant age and vehicle model year (stratified at pre- and post-2009). Logistic regression models were developed to examine the effects of various factors on injury risk (by body region), controlling for delta-V, sex, age, height, body mass index (BMI), vehicle model year (again stratified at 2009).
Results: Among other observations, these analyses indicate that newer model year vehicles (model year [MY] 2009 and later) carry less risk of Abbreviated Injury Scale (AIS) 2+ and AIS 3+ injury compared to older model year vehicles, with odds ratios of 0.69 (AIS 2+) and 0.45 (AIS 3+). The largest reductions in risk between newer model year vehicles and older model year vehicles occur in the lower extremities and in the risk of skull fracture. There is no statistically significant change in risk of AIS 3+ rib fracture or sternum injury between model year categories. Females are at greater risk of AIS 2+ and AIS 3+ injury compared to males, with increased risk across most injury types.
Conclusions: For belted occupants in frontal collisions, substantial reductions in injury risk have been realized in many body regions in recent years. Risk reduction in the thorax has lagged other body regions, resulting in increasing prevalence among skeletal injuries in newer model year vehicles (especially in the elderly). Injuries also remain common in the arm and hand/wrist for all age ranges studied. These results provide insight into where advances in the field have made gains in occupant protection and what injury types remain to be addressed. 相似文献